Individual
MRS. JAIMIE SUZANNE CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
6468 STATE HIGHWAY 77, BENTON, MO 63736-8237
(573) 545-3565
(573) 545-3491
Mailing address
6468 STATE HIGHWAY 77, BENTON, MO 63736-8237
(573) 545-3565
(573) 545-3491
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2015004268
MO
Other
Enumeration date
02/12/2015
Last updated
02/12/2015
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